Jason Flatt, an assistant professor in the School of Public Health’s Department of Social and Behavioral Health, is a leader in research related to older sexual and gender minority populations, or LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, as well as additional identities). He works to better understand the health concerns and needs of the members of these communities living with Alzheimer’s and Parkinson’s disease as well the experiences of their care providers.
Recently, Flatt was awarded a five-year, $3.5M grant from the National Institutes of Health (NIH) for his project, “Enhancing Measurement and Characterizations of Roles and Experiences of Sexual and Gender Minority Caregivers of Persons Living with Alzheimer’s Disease and Related Dementias.”
With this national grant, Flatt aims to change the way we measure who is a caregiver. He notes there are 11 million caretakers in the U.S. who are providing care to someone with dementia and an estimated 1 million of them are LGBTQIA+ adults.
Why is it important to define the term “caregiver”?
We are seeing a shift in the U.S. For the first time in our history. We have a large population of older people and not enough caregivers, and this is going to continue to grow. If we don’t catch up with the way that we truly define and measure who is a caregiver, we’re not going to be able to support this growing population of older people or those providing the care.
When we think of the diversity of the LGBTQIA+ caregivers, there’s a huge challenge in how we measure the elements of caregiving — everything from the role, strengths, challenges, and social and health needs. Most of the current federal and state services for caregivers are designed for a spouse and/or for biological family members caring for a parent or family member, but we don’t know how to meet the needs of LGBTQIA+ caregivers who don’t fit into those categories.
For example, to be eligible for services you often have to live with the care recipient, and this model doesn’t fit our reality. You may be caring for a friend who doesn’t live with you, they could live next door, or in the same community as you, but you’re not eligible to access services and resources even though you may be doing the same level of care for the person with dementia as someone who lives with their care recipient.
And LGBTQIA+ caregivers are not the only people who are impacted by having these diverse backgrounds, so by redefining these measures it is going to make it better for everyone.
What makes this particular grant different from others you've received?
All the grants I received before this one have been geared toward a “junior” or “early career” researcher and are often called “rising star” awards. But this grant is the one you are supposed to get when you are considered a prestigious researcher at an R1 institution. I got teary eyed when I received the email that said I was going to be funded. This is THE grant I’ve been training for my entire career.
What prepared you for receiving this grant?
My early grants provided the preliminary work I needed to support this research award. I’ve spent five years training and learning about LGBTQIA+ dementia and caregiving research.
As early-career faculty, I had a that looked into the risk of Alzheimer’s disease and related dementias in the LGBTQIA+ community, then I got an R24 NIH grant that was focused on building a research registry to recruit people experiencing memory loss, or Alzheimer’s disease, who were LGBTQIA+ as well as LGBTQIA+ caregivers of persons with memory loss or Alzheimer’s disease.
I also have a Michael J. Fox Foundation grant that expands this research to look at the unique needs of LGBTQIA+ people living with Parkinson’s disease as well as their caregivers.
In my research, not only do I think about what are the risks or concerns for people who are LGBTQIA+ and what are their health needs, but also how do they get the care and support they need for the best quality of life. I am super proud and really grateful that I get to do this type of research that impacts the lives of a community I’m a part of.
How will the $3.5M grant be used?
Most of it will be spent on doing the research. We will create two large advisory boards. One is a group of advisors who are experts in caregiving for people with Alzheimer’s disease from across the country. The other advisory board consists of leaders and experts involved in LGBTQIA+ aging, caregiving, or Alzheimer’s disease. All the board members will receive an annual honorarium to advise us on all the steps of this research.
We will also spend funds on recruiting LGBTQIA+ caregivers who are caring for someone with Alzheimer’s disease. We want to hear about their experiences and their challenges so we can learn more about the different areas and aspects of caregiving that we need to consider in what we measure, and not only are we going to talk with them, we will also pay them for their time.
We will then take the findings from the advisory boards and the caregivers to create new measures that we will take out into the community for their input. We’re going to do some targeted outreach efforts like go to different LGBTQIA+ events, and build trust with the community. Because if the community doesn’t agree with our measures or doesn’t think they will work, there is no reason to put these measures out there. We don’t want to develop these measures and then they sit somewhere and never be used.
Our goal is to create this list of new measures that other researchers can use, and I would love for someone to take them and make them even better and share their work with others. The goal is not for us to do this and hide the measures away. I want this to be something that helps the LGBTQIA+ community and helps other researchers.
These efforts will ultimately get at the unique concerns of LGBTQIA+ caregivers and their care recipients living with Alzheimer’s disease with the hope that we can improve access to care and that these measures might be able to help with testing innovative programs, interventions, or services to show how well they work for the LGBTQIA+ community.
Will you also be able to involve students in your research?
The funds will also be used to support student researchers. These early career researchers have really great ideas. They have experiences and they can see solutions from a different perspective.
Just the other day I was saying I didn’t like the way we were asking a question. There was me, the professor with a Ph.D., my other staff member who has a master’s degree, and it was the undergrad student who came up with the new wording. So I think the perspective that students bring to our research is so important. We have the opportunity to train them in developing new skills they wouldn’t have the chance to gain without participating in research, and my hope is it gets them excited about research and that they decide maybe this is the career for them.
Our team is made up of LGBTQIA+ students and LGBTQIA+ allies who want to work in this research area. I’ve heard that the students really love this work, especially if they are a member of our community or have a close friend or family member who is. It’s great to be involved with a group of researchers who are highly knowledgeable, care about our communities, and are really passionate about this work. When we, together, share these skills, passion, and learning, we get to be a part of something that is bigger than all of us.
What’s it like being a mentor to others in the research field?
With this grant, I am now ready to mentor others. I mentor a lot of different people, but I was always nervous that I hadn’t demonstrated that I can get the BIG grant, the one you are supposed to get when you are no longer an early-career researcher. And now I have.
I am super proud about this award, and I certainly did not do this by myself. There are so many people who have trained me, helped me, and supported me on my path to getting this award, and that’s the way I feel about mentoring others. Their success is my success. When others see [my mentees] do extremely well and they find out that I’ve been involved, they know – by proxy – I’ve been supporting them. And that’s what is at the center of my mentoring philosophy.
I stress a model of working together to improve people’s lives, getting people excited about research that aims to improve other people’s lives, and trying to have fun. I have my own mentor here at 51ԹϺ, Dr. Keith Whitfield. Dr. Whitfield has done amazing things for our university and for our research field; I highly respect him as a mentor, researcher, and president of 51ԹϺ.
You started your research career at UC San Francisco. What brought you to 51ԹϺ?
The Bay Area was incredible for launching my research. It shaped my knowledge and the mentoring I received there over five years was amazing, but I would say it’s just as robust here at 51ԹϺ. Nevada is number three in the country for the percentage of LGBTQIA+ people. My husband and I knew we wanted to move to a diverse place that honors people for their differences and does not exclude them because of it.
I can be a leader in the LGBTQIA+ research space here because of what I learned in San Francisco. Last year, I drove a convertible in the Pride Parade. I’m a judge for the Pride Parade floats, and I get to partner with our local LGBT Center ().
I also connected the School of Dental Medicine with The Center so they can start collaborating on pop-up dental clinics. That way we can offer community members dental screenings and encourage them to come to the dental school’s student clinics to get the work they need at a lower cost. These are the unique things I get to do here. UCSF was huge and even though I was super ambitious and made some things happen there, I could never match what is possible here at 51ԹϺ and in Vegas.
The other reason I came to 51ԹϺ is to be part of a school that is growing. I had always been in places that were already established, so I was excited to join the 51ԹϺ School of Public Health in 2020. Shortly after I joined, my department (Social and Behavioral Health) was created! There is just so much opportunity. I feel I can lead research in Las Vegas and build educationally, financially, and socially with less limitations. It’s really an incredible place!
For your photoshoot, a special object was incorporated. What is the object that represents you or your work, and why is it meaningful to you?
The object I chose was The Progress Pride flag. I chose this item because it reflects the diversity of our LGBTQIA+ community. The Pride flag was created in 1978, but it wasn’t until recently (2018) that we redesigned the flag to celebrate our diversity and ensure transgender, non-binary, and intersex communities and LGBTQIA+ communities of color were included. It is meaningful and important to me that my research, teaching, and community service support all of our diverse LGBTQIA+ community members. The Progress Pride Flag symbolizes that for me.
